Botulinim Toxin Type A Injections by Different Guidance in Stroke Patients With Spasticity on Upper Extremities

NCT ID: NCT02557737

Last Updated: 2016-03-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-09-30

Study Completion Date

2016-07-31

Brief Summary

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The aims of this study were to compare the injection locations of key spastic muscles on upper extremity by three different guidance localization methods ( surface anatomy landmark, ultrasonography, electric stimulation) and the effectiveness.

Detailed Description

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Stroke may result in acute or chronic hemiplegia and spasticity in stroke patients. Spasticity in upper extremities may interfere with motor voluntary function, activities of daily living and cause muscle pain. Botulinum toxin type A (BTX-A) has been shown to relieve spasticity and pain in upper extremities of stroke patients. There are no researches to compare the efficiency of BTX-A by different injection guidance methods in stroke patients. The aims of our study were to compare the injection locations of key spastic muscles on upper extremity by three different guidance localization methods ( surface anatomy landmark, ultrasonography, electric stimulation) and the effectiveness. The investigators will enroll 60 hemiplegic stroke patients with upper extremity spasticity more than modified Ashworth scale ( MAS) 1+ and duration more than 6 months. Under different guidance methods (surface anatomy landmark/ ultrasonography /electric stimulation ), BTX-A will be injected to the key spastic muscles on upper extremity. Outcome measures include MAS, motor function ( Brunnstrom stage of upper extremity), range of motion , the degree and visual analog scale of pain , pinch and grasp power,Stroke Impact Scale, Barthel index and upper extremity function (Nine hole peg test,Action Reaearch Arm Test,Wolf Motor Function test,Chedoke Arm and Han Activity Inventory,Fugl-Meyer Assessment Scale,Motor Activity Log). All the assessments will be performed before BTX-A injection and followed up at 4 weeks, 8 weeks, 12 weeks and 24 weeks after injection. After performing all the assessments, investigators will investigate the efficiency of BTX-A by different guidance methods.

Four of arms:

ultrasonography direct-guidance: To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by Ultrasonography direct-guidance.

ultrasonography indirect-guidance: To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by Ultrasonography indirect-guidance.

electric stimulation guidance: To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by electric stimulation guidance.

surface anatomy landmark: To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by surface anatomy landmark.

Conditions

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Cerebrovascular Accident

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Ultrasonography direct-guidance

To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by Ultrasonography direct-guidance.

Group Type EXPERIMENTAL

Botulinum Toxin Type A

Intervention Type DRUG

To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by Ultrasonography direct-guidance, Ultrasonography direct-guidance, Electric stimulation and Surface anatomy landmark.

Electric stimulation

To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by Electric stimulation

Group Type EXPERIMENTAL

Botulinum Toxin Type A

Intervention Type DRUG

To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by Ultrasonography direct-guidance, Ultrasonography direct-guidance, Electric stimulation and Surface anatomy landmark.

Surface anatomy landmark

To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by Surface anatomy landmark.

Group Type ACTIVE_COMPARATOR

Botulinum Toxin Type A

Intervention Type DRUG

To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by Ultrasonography direct-guidance, Ultrasonography direct-guidance, Electric stimulation and Surface anatomy landmark.

Interventions

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Botulinum Toxin Type A

To inject Botulinum toxin type A on the spasticity lower extremity for stroke patients by Ultrasonography direct-guidance, Ultrasonography direct-guidance, Electric stimulation and Surface anatomy landmark.

Intervention Type DRUG

Other Intervention Names

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Botulinum toxin

Eligibility Criteria

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Inclusion Criteria

* first onset.
* at least onset before 6 months.
* elbow, wrist and fingers are above Modified Ashworth Scale(MAS) 1+.
* Mini-Mental State Exam above 24.
* can follow all of the follow up and instruction.
* patients never accept botox, phenol and alcohol injections before.

Exclusion Criteria

* contracture deformity on upper extremity.
* patients had accepted botox before or had have phenol, alcohol injections and operation 6 months ago.
* allergy to botox.
* have neither infection nor skin disorder on inject site.
* now accept aminoglycoside or other medicine treatment which may affect neuromuscular transition.
* combine other systemic disease of neurological or skelectomuscular system
* cognition disorder or aphasia after stroke.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Chang Gung Memorial Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pong Ya-Ping, MD

Role: STUDY_CHAIR

Rehabilitation

Locations

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Chang Gung Memorial Hospital

Kaohsiung City, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Pong Ya-Ping, MD

Role: CONTACT

889-7-7317123 ext. 6286

Facility Contacts

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Pong Ya-ping, MD

Role: primary

889-7-7317123 ext. 6286

References

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Reference Type BACKGROUND
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Gracies JM, Elovic E, McGuire J, Simpson DM. Traditional pharmacological treatments for spasticity. Part I: Local treatments. Muscle Nerve Suppl. 1997;6:S61-91.

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Other Identifiers

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CMRPG8B0222

Identifier Type: -

Identifier Source: org_study_id

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